Fracture risk is increased with canagliflozin treatment, according to 2 analyses involving 10,194 individuals.

Investigators looked at 8 studies involving canagliflozin (n=5,867) . Separately, they analyzed data from the CANVAS trial (n=4,327).

Among the results:

• The incidence of fractures was similar with (1.7%) and without (1.5%) canagliflozin in the pooled studies.

• Conversely, a significant rise in fracture incidence was seen with canagliflozin (4.0%) vs placebo (2.6%) in the CANVAS study.

• The overall incidence of fractures was higher with (2.7%) vs without (1.9%) canagliflozin, driven by the increase in CANVAS.

• The overall incidence adverse events due to falls was low, but significantly higher with those taking canagliflozin in CANVAS.

The authors noted that CANVAS had an older patient profile with higher CV risk, lower baseline eGFR and higher diuretic use. The increase in fractures could be explained by falls. Still, the cause of increased fracture risk with canagliflozin is unknown.

Citation: Watts, N, Bilezikian J, Usiskin K, et al. Effects of canagliflozin on fracture risk in patients with type 2 diabetes mellitus. [Published online ahead of print November 18, 2015]. J Clin Endocrinol Metab. doi: http://dx.doi.org/10.1210/jc.2015-3167.